Clinics in diagnostic imaging (3). Acute-on-chronic pancreatitis causing diabetic ketoacidosis

A 49-year-old man presented with clinical and biochemical features of diabetic ketoacidosis and concomitant acute pancreatitis. Plain radiographs, computerised tomography (CT) and endoscopic retrograde cholangiopancreatogram demonstrated changes of chronic pancreatitis, which was the cause of exocrine pancreatic insufficiency in this patient. Advantages and disadvantages of various imaging modalities in the diagnosis and management of pancreatitis are discussed. Imaging features of acute and chronic pancreatitis, and associated complications, are described.